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Bone Density (bone + density)
Kinds of Bone Density Selected AbstractsAssociation Between Changes in Habitual Physical Activity and Changes in Bone Density, Muscle Strength, and Functional Performance in Elderly Men and WomenJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2008Robin M. Daly PhD OBJECTIVES: To investigate the long-term effects of habitual physical activity on changes in musculoskeletal health, functional performance, and fracture risk in elderly men and women. DESIGN: Ten-year prospective population-based study. SETTING: Malmö-Sjöbo Prospective Study, Sweden. PARTICIPANTS: Participants were 152 men and 206 women aged 50, 60, 70, and 80 who were followed for 10 years. MEASUREMENTS: Distal radius bone mineral density (BMD) (single photon absorptiometry), upper limb muscle (grip) strength, balance, gait velocity, occupational and leisure-time activity, and fractures (interview-administered questionnaire) were reassessed after 10 years. Annual changes for all measures were compared between participants with varying habitual physical activity histories at baseline and follow-up: inactive,inactive (n=202), active,inactive (n=47), inactive,active (n=49), and active,active (n=60). Data for men and women were pooled, because there were no sex-by-activity group interactions. To detect possible differences in fracture incidence between the varying habitual activity groups, participants were classified into two activity groups based on their activity classification at baseline and follow-up: inactive:less active versus active:more active. RESULTS: The annual rate of bone loss was 0.6% per year less in individuals classified as active at both time points than in those classified as inactive at both time points (P<.01). Similar results were observed for balance, but there was no effect of varying habitual activity on changes in muscle strength or gait velocity. There were also no differences in fracture incidence between individuals categorized as active:more active and those categorized as inactive:less active during the follow-up (adjusted hazard ratio=0.90, 95% confidence interval (CI)=0.42,1.90). CONCLUSION: This study showed that elderly men and women who maintained a habitually active lifestyle over 10 years had lower bone loss and retained better balance than those who remained habitually inactive. [source] Estrogen Receptor , Gene Polymorphisms and Peak Bone Density in Chinese Nuclear Families,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 6 2003Yue-Juan Qin Abstract PBD is an important determinant of osteoporotic fractures. Few studies were performed to search for genes underlying PBD variation in Chinese populations. We tested linkage and/or association of the estrogen receptor , gene polymorphism with PBD in 401 Chinese nuclear families. This study suggests the ER-, gene may have some minor effects on PBM variation in the Chinese population. Low peak bone density (PBD) in adulthood is an important determinant of osteoporotic fractures in the elderly. PBD variation is mainly regulated by genetic factors. Extensive molecular genetics studies have been performed to search for genes underlying PBD variation, largely in whites. Few studies were performed in Chinese populations. In this study, we simultaneously test linkage and/or association of the estrogen receptor , (ER -,) gene polymorphism with PBD in 401 Chinese nuclear families (both parents plus their female children) of 1260 subjects, with the 458 children generally between 20 and 40 years of age. All the subjects were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) at polymorphic PvuII and XbaI sites inside the ER -, gene. Bone mineral density was measured at the lumbar spine (L1-L4) and hip (femoral neck, trochanter, and intertrochanteric region). Raw bone mineral density values were adjusted by age, height, and weight as covariates. We detected marginally significant results for within-family association (transmission disequilibrium; p = 0.054) between the spine bone mineral density variation and the ER -, XbaI genotypes. For the hip bone mineral density variation, significant (p < 0.05) linkage results were generally found for the two intragenic markers. Analyses of the haplotypes defined by the two markers confer further evidence for linkage of the ER -, with the hip PBD variation. In conclusion, this study suggests that the ER -, gene may have minor effects on PBD variation in our Chinese population. [source] Changes in Bone Density During Childhood and Adolescence: An Approach Based on Bone's Biological OrganizationJOURNAL OF BONE AND MINERAL RESEARCH, Issue 4 2001Frank Rauch Abstract Bone densitometry has great potential to improve our understanding of bone development. However, densitometric data in children rarely are interpreted in light of the biological processes they reflect. To strengthen the link between bone densitometry and the physiology of bone development, we review the literature on physiological mechanisms and structural changes determining bone mineral density (BMD). BMD (defined as mass of mineral per unit volume) is analyzed in three levels: in bone material (BMDmaterial), in a bone's trabecular and cortical tissue compartments (BMDcompartment), and in the entire bone (BMDtotal). BMDmaterial of the femoral midshaft cortex decreases after birth to a nadir in the first year of life and thereafter increases. In iliac trabecular bone, BMDmaterial also increases from infancy to adulthood, reflecting the decrease in bone turnover. BMDmaterial cannot be determined with current noninvasive techniques because of insufficient spatial resolution. BMDcompartment of the femoral midshaft cortex decreases in the first months after birth followed by a rapid increase during the next 2 years and slower changes thereafter, reflecting changes in both relative bone volume and BMDmaterial. Trabecular BMDcompartment increases in vertebral bodies but not at the distal radius. Quantitative computed tomography (QCT) allows for the determination of both trabecular and cortical BMDcompartment, whereas projectional techniques such as dual-energy X-ray absorptiometry (DXA) can be used only to assess cortical BMDcompartment of long bone diaphyses. BMDtotal of long bones decreases by about 30% in the first months after birth, reflecting a redistribution of bone tissue from the endocortical to the periosteal surface. In children of school age and in adolescents, changes in BMDtotal are site-specific. There is a marked rise in BMDtotal at locations where relative cortical area increases (metacarpal bones, phalanges, and forearm), but little change at the femoral neck and midshaft. BMDtotal can be measured by QCT at any site of the skeleton, regardless of bone shape. DXA allows the estimation of BMDtotal at skeletal sites, which have an approximately circular cross-section. The system presented here may help to interpret densitometric results in growing subjects on a physiological basis. [source] Assessing Bone Density in MenJOURNAL OF BONE AND MINERAL RESEARCH, Issue 10 2000Eric Orwoll M.D. First page of article [source] Premenopausal Smoking and Bone Density in 2015 Perimenopausal WomenJOURNAL OF BONE AND MINERAL RESEARCH, Issue 4 2000Dr. A. P. Hermann Abstract The importance of cigarette smoking in relation to bone mass remains uncertain, especially in younger women. In a recent meta-analysis including 10 studies in premenopausal women no effect was seen in this age group. We used baseline data from a large national cohort study (Danish Osteoporosis Prevention Study [DOPS]) to study the cumulated effect of pre- and perimenopausal smoking on bone mineral density (BMD) measured shortly after the cessation of cyclic bleedings. Baseline observations on 2015 recently menopausal women were available. Eight hundred thirty-two women were current smokers and 285 were exsmokers. Significant negative associations of cigarette smoking coded as current, ex-, or never smoking were seen on bone mass in the lumbar spine (P = 0.012), femoral neck (P < 0.001), and total body (P < 0.001). Quantitatively, the differences between current smokers and never smokers were limited to 1.6, 2.9, and 1.9%, respectively. A statistical interaction was found between smoking and fat mass, indicating that women in the highest tertile of fat mass were unaffected by cigarette smoking. Serum vitamin D levels and osteocalcin were inversely related to the number of cigarettes smoked per day (r = 0.11 and P < 0.001; r = 0.17 and P = 0.04), respectively. Bone alkaline phosphatase (BALP) and urinary hydroxyproline (U-OHP) were unaffected by current smoking. The average cumulated effect of premenopausal smoking on bone is small but biologically significant. Reduced body mass in smokers explains part of the negative effect on the skeleton and a complex interaction between smoking and fat mass on the skeleton is indicated. Serum levels of 25-hydroxyvitamin D (25-OHD) and osteocalcin are lower in smokers, which may effect rate of bone loss. [source] A Detailed Assessment of Alterations in Bone Turnover, Calcium Homeostasis, and Bone Density in Normal PregnancyJOURNAL OF BONE AND MINERAL RESEARCH, Issue 3 2000A. J. Black Abstract The effects of pregnancy on bone turnover and the potential risk of developing an osteoporotic fracture in pregnancy are controversial. Utilizing biochemical markers of bone formation and resorption and dual-energy X-ray absorptiometry (DEXA), bone turnover before, during, and after pregnancy was studied in detail. Ten women (mean age 30 years; range 23,40) were recruited. Prepregnancy data were obtained and then a review was performed at 2-week intervals, once pregnancy was confirmed, until 14 weeks of gestation and thereafter monthly until term. Bone mineral density (BMD) was estimated by DEXA scanning of hip, spine, and forearm preconception and postpartum. In addition, BMD of the forearm at 14 weeks and 28 weeks gestation was obtained. All pregnancies had a successful outcome. Urinary free pyridinium cross-links, free pyridinoline (fPyr) and free deoxypyridinoline (fDPyr), were normal prepregnancy (mean [±SD]) 14.6 nmol/mmol (1.8) and 5.0 nmol/mmol (1.0) creat, respectively. By 14 weeks, they had increased to 20.8 nmol/mmol (4.3) and 6.1 nmol mmol (1.4) (both p < 0.02) and by 28 weeks to 26.3 nmol/mmol (5.6) and 7.4 nmol/mmol (1.6) (both p < 0.01). The ratio of fPyr to fDPyr remained constant. A similar significant increase was observed in N-telopeptide (NTx). Bone formation was assessed by measurement of carboxy-terminal propeptide of type 1 collagen (P1CP) and bone-specific alkaline phosphatase (BSAP). Neither were altered significantly before 28 weeks, but subsequently mean P1CP increased from 110 ,g/liter (23) to 235 ,g/liter (84) at 38 weeks and mean BSAP increased from 11.1 U/liter (5.0) to 28.6 U/liter (11.1) (p < 0.01 for both variables). Lumbar spine (L1,L4) BMD decreased from a prepregnancy mean of 1.075 g/cm (0.115) to 1.054 g/cm2 (0.150) postpartum (p < 0.05). Total hip BMD decreased from a prepregnancy mean of 0.976 g/cm2 (0.089) to 0.941 g/cm2 (0.097) (p < 0.05). Forearm BMD at midradius, one-third distal and ultradistal decreased but did not reach statistical significance. As assessed by these bone markers, in the first 2 trimesters of pregnancy, bone remodeling is uncoupled with a marked increase in bone resorption. A corresponding increase in formation markers is not observed until the third trimester. Spinal BMD exhibits a significant decrease from prepregnancy to the immediate postpartum period with a mean reduction in BMD of 3.5% in 9 months. [source] Effect of a Comprehensive Lifestyle Modification Program on the Bone Density of Male Heavy DrinkersALCOHOLISM, Issue 5 2010Toshifumi Matsui Background:, Heavy alcohol drinking is implicated in osteoporosis. Although abstinence is rapidly followed by a restoration of osteoblastic activity, little is known about the contributions of alcohol-related factors or the effectiveness of a lifestyle modification program (LMP) on bone density. Methods:, We conducted a study of 138 male alcoholic patients to investigate whether drinking history and concurrent factors were associated with the bone density of the calcaneus. A 2.5-months LMP in an institutionalized setting was completed by 20 of them, and its effect on bone density, serum parathyroid hormone (PTH), and 1.25-(OH)2 vitamin D levels were assessed. Results:, The patients had a high prevalence of daytime drinking (93.5%), continuous drinking (84.1%), and current smoking (82.0%) with mean duration of alcohol abuse of 30.0 ± 12.8 years. The patients had lower bone density than a reference control group (Z-scores: ,0.45 ± 1.02). Multiple stepwise regression analysis identified age, poor activities of daily living (ADL), continuous drinking, absence of liver cirrhosis, depression, and dementia as determinants of low bone density. The bone density of the 20 participants in the LMP improved 2.3% (p = 0.0003) with a more ameliorating effect on bone density than a conventional abstinence therapy (p = 0.014 for interventional effect). The upper normal range of PTH levels at baseline were significantly decreased, and 1.25-(OH)2 vitamin D levels also had a trend toward decrease during the abstinence. Conclusions:, Alcoholic patients may have many complications such as poor ADL and dementia, which are independently associated with decreased bone density. The results of this study support the idea that comprehensive approach to lifestyle factors to minimize risk of osteoporosis is the best way to improve bone density. [source] Cutting Torque Measurements in Conjunction with Implant Placement in Grafted and Nongrafted Maxillas as an Objective Evaluation of Bone Density: A Possible Method for Identifying Early Implant Failures?CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2004Björn Johansson DDS ABSTRACT Background: Bone grafts are frequently used to enable the placement of dental implants in atrophied jaws. The biomechanical properties of bone grafts used in one- or two-stage implant procedures (in comparison with the use of nongrafted bone) are not well known. Purpose: The purpose of this study was (1) to measure cutting torques during the placement of self-tapping dental implants in nongrafted bone and in bone grafts, either as blocks or in a milled particulate form, in patients undergoing implant treatment in an edentulous maxilla and (2) to identify implants with reduced initial stability and to correlate these findings with a clinical classification of jawbone quality. Materials and Methods: The study included 40 consecutive patients with edentulous maxillas, 27 of whom were subjected to bone grafting prior to or in conjunction with implant placement (grafting group) and 13 of whom received implants without grafting (nongrafted group). Grafted bone from the iliac crest bone was used (1) as onlay blocks, (2) as maxillary sinus inlay blocks, or (3) in particulate form in the maxillary sinus. Implants were placed after 6 to 7 months of healing, except in the maxillary sinus inlay blocks, where implants were placed simultaneously. Cutting torque values were obtained from 113 grafted implant sites and from 109 nongrafted implant sites. Results: Significantly lower cutting torque values were assessed in grafted regions than in nongrafted regions, irrespective of grafting technique. Lower values were also seen for implants placed in block grafts after 6 months when compared to other grafting techniques used. The cutting torque values revealed an inverse linear relation to the Lekholm and Zarb bone quality index. Conclusion: The cutting torque values correlated well with the Lekholm and Zarb index of bone quality. Significantly lower cutting torque values were seen in grafted bone than in nongrafted bone. [source] Physical activity for prevention of osteoporosis in patients with severe haemophilia on long-term prophylaxisHAEMOPHILIA, Issue 3 2010M. KHAWAJI Summary., Physical activity has been considered as an important factor for bone density and as a factor facilitating prevention of osteoporosis. Bone density has been reported to be reduced in haemophilia. To examine the relation between different aspects of physical activity and bone mineral density (BMD) in patients with severe haemophilia on long-term prophylaxis. The study group consisted of 38 patients with severe haemophilia (mean age 30.5 years). All patients received long-term prophylaxis to prevent bleeding. The bone density (BMD g cm,2) of the total body, lumbar spine, total hip, femoral neck and trochanter was measured by dual energy X-ray absorptiometry. Physical activity was assessed using the self-report Modifiable Activity Questionnaire, an instrument which collects information about leisure and occupational activities for the prior 12 months. There was only significant correlation between duration and intensity of vigorous physical activity and bone density at lumber spine L1-L4; for duration (r = 0.429 and P = 0.020) and for intensity (r = 0.430 and P = 0.019); whereas no significant correlation between all aspects of physical activity and bone density at any other measured sites. With adequate long-term prophylaxis, adult patients with haemophilia are maintaining bone mass, whereas the level of physical activity in terms of intensity and duration play a minor role. These results may support the proposition that the responsiveness to mechanical strain is probably more important for bone mass development in children and during adolescence than in adults and underscores the importance of early onset prophylaxis. [source] Bone disorders in chronic liver disease,HEPATOLOGY, Issue 4 2007Jane Collier Osteomalacia rarely occurs in adult patients with chronic liver disease despite a low serum vitamin D level being reported in up to two-thirds of patients with cirrhosis. In contrast, osteoporosis, which increases the risk of vertebral fractures, occurs in 12%-55% of patients with cirrhosis. Although the prevalence is probably falling, as shown by a fall from 57%-26% in patients with biliary disease requiring liver transplantation over the last 2 decades, it still accounts for significant patient morbidity. Bone density also falls in the first 3 months after liver transplantation, and pretransplant fractures are predictive of posttransplant fractures. Many of the known risk factors for postmenopausal osteoporosis exist in the cirrhotic population, such as excess alcohol intake, steroid use, poor nutrition, and hypogonadism. There is also an increased risk of osteoporosis in patients without cirrhosis, particularly those with hemochromatosis and biliary disease. The diagnosis is made with bone density measurements. The effective treatment is largely based on evidence from postmenopausal osteoporosis as there have been only a few small clinical trials of patients with chronic liver disease. Bisphosphonates are the mainstay of treatment; they have been shown to be effective in biliary disease and are well tolerated. (HEPATOLOGY 2007.) [source] Evaluation of implants coated with rhBMP-2 using two different coating strategies: a critical-size supraalveolar peri-implant defect study in dogsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2010Jaebum Lee Lee J, Decker JF, Polimeni G, Cortella CA, Rohrer MD, Wozney JM, Hall J, Susin C, Wikesjö UME. Evaluation of implants coated with rhBMP-2 using two different coating strategies: a critical-size supraalveolar peri-implant defect study in dogs. J Clin Periodontol 2010; 37: 582,590. doi: 10.1111/j.1600-051X.2010.01557.x. Abstract Background: Implants coated with recombinant human bone morphogenetic protein-2 (rhBMP-2) induce relevant bone formation but also resident bone remodelling. Objectives: To compare the effect of implants fully or partially coated with rhBMP-2 on new bone formation and resident bone remodelling. Materials and Methods: Twelve, male, adult, Hound Labrador mongrel dogs were used. Critical-size, supraalveolar, peri-implant defects received titanium porous oxide surface implants coated in their most coronal aspect with rhBMP-2 (coronal-load/six animals) or by immersion of the entire implant in an rhBMP-2 solution (soak-load/six animals) for a total of 30 ,g rhBMP-2/implant. All implants were air-dried. The animals were euthanized at 8 weeks for histometric evaluation. Results: Clinical healing was uneventful. Supraalveolar bone formation was not significantly affected by the rhBMP-2 application protocol. New bone height and area averaged (± SE) 3.4 ± 0.2 versus 3.5 ± 0.4 mm and 2.6 ± 0.4 versus 2.5 ± 0.7 mm2 for coronal-load and soak-load implants, respectively (p>0.05). The corresponding bone density and bone,implant contact (BIC) recordings averaged 38.0 ± 3.8%versus 34.4 ± 5.6% and 25.0 ± 3.8%versus 31.2 ± 3.3% (p>0.05). In contrast, resident bone remodelling was significantly influenced by the rhBMP-2 application protocol. Bone density outside the implants threads averaged 74.7 ± 3.8% and 50.8 ± 4.1% for coronal-load and soak-load implants, respectively (p<0.05); bone density within the thread area averaged 51.8 ± 1.2% and 37.8 ± 2.9%, and BIC 70.1 ± 6.7% and 43.3 ± 3.9% (p<0.05). Conclusion: Local application of rhBMP-2 appears to be a viable technology to support local bone formation and osseointegration. Coronal-load implants obviate resident bone remodelling without compromising new bone formation. [source] Tooth loss and osteoporosis: the osteodent studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2009Kety Nicopoulou-Karayianni Abstract Aim: To determine the cross-sectional association of the osteoporotic status of patients with the number of their teeth, with and without taking into account age and/or smoking. Material & Methods: At four centres, the study recruited 665 females aged 45,70 years and the number of teeth was counted for 651 subjects. Bone density was measured at the total hip, femoral neck and lumbar spine. Results: The mean number of teeth in the osteoporotic subjects was 3.3 fewer than normal subjects and 2.1 fewer if those with no teeth were excluded. The association between osteoporosis and having <6 or having <28 teeth remained significant after adjusting for age, smoking and centre with p -values of 0.016 and 0.011, respectively. A single regression model for tooth count with normal errors would not fit all the data. By fitting mixture regression models to subjects with tooth count >0, three clusters were identified corresponding to different degrees of tooth loss. The overall effect of osteoporosis was as follows: ,1.8 teeth before and after adjusting for smoking, ,1.2 teeth after adjusting for age, and ,1.1 teeth after adjusting for both age and smoking. Conclusions: We have established a significant association between osteoporosis and tooth loss after adjusting the effect for age and smoking. [source] Influence of bone density on the cement fixation of femoral hip resurfacing componentsJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 8 2010Rudi G. Bitsch Abstract In clinical outcome studies, small component sizes, female gender, femoral shape, focal bone defects, bad bone quality, and biomechanics have been associated with failures of resurfacing arthroplasties. We used a well-established experimental setup and human bone specimens to analyze the effects of bone density on cement fixation of femoral hip resurfacing components. Thirty-one fresh frozen femora were prepared for resurfacing using the original instruments. ASRÔ resurfacing prostheses were implanted after dual-energy X-ray densitometer scans. Real-time measurements of pressure and temperature during implantation, analyses of cement penetration, and measurements of micro motions under torque application were performed. The associations of bone density and measurement data were examined calculating regression lines and multiple correlation coefficients; acceptability was tested with ANOVA. We found significant relations between bone density and micro motion, cement penetration, cement mantle thickness, cement pressure, and interface temperature. Mean bone density of the femora was 0.82,±,0.13,g/cm2, t- score was ,0.7,±,1.0, and mean micro motion between bone and femoral resurfacing component was 17.5,±,9.1,µm/Nm. The regression line between bone density and micro motion was equal to ,56.7,×, bone density,+,63.8, R,=,0.815 (p,<,0.001). Bone density scans are most helpful for patient selection in hip resurfacing, and a better bone quality leads to higher initial component stability. A sophisticated cementing technique is recommended to avoid vigorous impaction and incomplete seating, since increasing bone density also results in higher cement pressures, lower cement penetration, lower interface temperatures, and thicker cement mantles. © 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 28:986,991, 2010 [source] Intact fibula improves fracture healing in a rat tibia osteotomy modelJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 2 2005Sandra J. Shefelbine Abstract Rat tibia fractures are often used in fracture healing studies. Usually the fracture is stabilized with an intramedullary pin, which provides bending stiffness, but little torsional stiffness. The objective of this research was to determine the in vitro torsional rigidity of an osteotomized tibia with and without the fibula, and to determine if this difference influences the healing process in vivo. In vitro eleven rat tibias received an osteotomy, were stabilized with an intramedullary pin, and were tested in internal rotation to determine the torsional rigidity. The fibula was then manually broken and the torsional rigidity measured again. In vivo 18 rats received a tibial osteotomy, eight of which had an additional fractured fibula. After three weeks, the rats were sacrificed and the tibias were analyzed. Bone density in the fracture callus was measured with qCT. Bending rigidity and maximum breaking moment were determined in three-point bending. In vitro testing demonstrated that the torsional rigidity with an intact fibula was nearly two times higher than when the fibula was fractured. Though the torsional rigidity was still small in comparison with an intact bone, it resulted in a significantly different healing process in vivo. Rats with intact fibulas had significantly higher bone mineral density, bending rigidity, and maximum breaking moment compared to rats with a fractured fibula. These results indicate that torsional stability considerably affects the healing process. In a fracture model, it is critical to characterize the mechanical environment of the fracture. © 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source] Effects of 0.4 T rotating magnetic field exposure on density, strength, calcium and metabolism of rat thigh bonesBIOELECTROMAGNETICS, Issue 1 2006Xiao-yun Zhang Abstract The current study investigated the effects of 0.4 T rotary non-uniform magnetic field (RMF) exposure on bone density in ovariectomized (OVX) rats. Results showed that many bone indexes are significantly elevated after RMF exposure compared to the control OVX group and confirmed mechanistic evidence that strong magnetic field (MF) exposure could effectively increase bone density and might be used to treat osteoporosis. Synergy of daily RMF exposure (30 min a day for 30 days using an 8 Hz rotary 0.4 T MF) with calcium supplement tended to increase the indexes of thigh bone density, energy absorption, maximum load, maximum flexibility, and elastic deformation as compared to those of untreated OVX control group. Results also revealed that the indexes of alkaline phosphatase (ALP), serum phosphate, and serum calcium were higher in rats exposed to RMF with calcium than in the untreated OVX control group. Changes in bone mineral density (BMD) and bone mineral content (BMC) were observed in rats for three months including the first month RMF exposure. Bone density in rats exposed each day for 60 min increased during 1-month exposure and continued to increase during the post-exposure period. Furthermore, bone density and calcium content in rats exposed for 90 min daily decreased initially in the exposure month; however, ratio of increase was well above the control values by the end of the post-exposure period suggesting possible window and delayed effects. The study indicated that RMF exposure to both male and OVX female rats for 120 min a day over 15 day period should effectively promote increase of bone calcium contents (BCC) and bone-specific alkaline phosphatase (BAP) in rats thigh bone as well as a corresponding decrease in deoxypyridinoline crosslinks (DPD). Bioelectromagnetics 27:1,9, 2006. © 2005 Wiley-Liss, Inc. [source] KYNURENINE PATHWAY METABOLISM IN PATIENTS WITH OSTEOPOROSIS AFTER 2 YEARS OF DRUG TREATMENTCLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 11 2006Caroline M Forrest ABSTRACT 1Metabolism of tryptophan along the oxidative pathway via kynurenine results in the production of quinolinic acid and kynurenic acid, which can act on glutamate receptors in peripheral tissues. We have now measured the concentrations of kynurenine pathway metabolites in the plasma of patients with osteoporosis before treatment with drugs, throughout and after 2 years of treatment with the drugs raloxifene or etidronate. Oxidative stress was assessed by measuring levels of the lipid peroxidation products malondialdehyde and 4-hydroxynonenal. Kynurenines were analysed by HPLC. Bone density was measured using dual-energy X-ray absorptiometry scans. 2Patients with osteoporosis showed significantly lower baseline levels of 3-hydroxyanthranilic acid compared with healthy controls, but significantly higher levels of anthranilic acid and lipid peroxidation products. After 2 years treatment with etidronate and calcium, we observed significant therapeutic responses quantified by bone densitometric scanning. Significant improvements were not seen in patients treated with raloxifene. 3In parallel, the levels of 3-hydroxyanthranilic acid, anthranilic acid and lipid peroxidation products were restored to control values by both drug treatments studied and tryptophan levels were increased significantly compared with baseline values. 4The results suggest that tryptophan metabolism is altered in osteoporosis in a manner that could contribute to the oxidative stress and, thus, to progress of the disease. The oxidative metabolism of tryptophan (the kynurenine pathway) could represent a novel target for the development of new drugs for the treatment of osteoporosis. In addition, we noted that etidronate is a more effective drug than raloxifene, but that the simultaneous use of non-steroidal anti-inflammatory drugs may reduce the efficacy of etidronate. [source] Congenital adrenal hyperplasia in adults: a review of medical, surgical and psychological issuesCLINICAL ENDOCRINOLOGY, Issue 1 2006Cara Megan Ogilvie Summary Our knowledge of the experience of adults with congenital adrenal hyperplasia (CAH) as they pass through life is only now emerging. In this review we gather medical, surgical and psychological literature pertaining to adults with CAH and consider this alongside practical experience gained from a dedicated adult CAH clinic. There is increasing awareness for the need for multidisciplinary teams who have knowledge of CAH particularly with respect to gynaecological surgery and clinical psychology for women and testicular function in men. Routine management of CAH comprises adjustment of glucocorticoid and mineralocorticoid treatment according to individual needs balancing biochemical markers, compliance and long term risks. Bone density is one such long term concern and is not greatly reduced in most individuals with CAH. More recently, attention has turned to cardiovascular risk factors and catecholamine deficiency in adults with CAH. Women with CAH require access to an experienced gynaecologist, specialised pregnancy care and psychosexual support. The very low fertility rates for women with CAH previously reported appear to be improving with time. Men with CAH are often lost to follow up and therefore miss out on surveillance for hypogonadism either through the effect of adrenal rests of from suppression of gonadotrophins resulting in a high prevalence of oligospermia. [source] rhBMP-2/,BSM® Induces Significant Vertical Alveolar Ridge Augmentation and Dental Implant OsseointegrationCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2002Ulf M.E. Wikesjö DDS ABSTRACT Background: Recombinant human bone morphogenetic protein 2 (rhBMP-2) in a carrier has been shown to induce significant bone formation. Several candidate carriers, however, lack structural integrity to offset compressive forces that may compromise rhBMP-2 bone induction, in particular, for challenging onlay indications such as alveolar ridge augmentation. Purpose: The objective of this study was to evaluate rhBMP-2 in a calcium-phosphate cement carrier, ,BSM, for vertical alveolar ridge augmentation and immediate dental implant Osseointegration. Materials and Methods: Six adult Hound Labrador mongrels with 5 mm critical size supra-alveolar peri-implant defects were used. Three animals received rhBMP-2/,BSM (rhBMP-2 at 0.40 and 0.75 mg/mL) in contralateral jaw quadrants (total implant volume/defect , 1.5 mL). Three animals received ,BSM without rhBMP-2 (control group). The animals were euthanized at 16 weeks post surgery, and block biopsies were processed for histologie and histometric analysis. Results: rhBMP-2/,BSM induced substantial augmentation of the alveolar ridge. Control sites exhibited limited new bone formation. Vertical bone augmentation averaged (SD) 4.9 ± 1.0 mm (rhBMP-2 at 0.40 mg/mL), 5.3 ± 0.3 mm (rhBMP-2 at 0.75 mg/mL), and 0.4 ± 0.4 mm (control); new bone area 8.5 ± 4.2 mm 2, 9.0 ± 1.9 mm 2, and 0.5 ± 0.4 mm 2; new bone density 55.1 ± 6.4%, 61.1 ± 6.0%, and 67.7 ± 9.5%; and new bone-implant contact 26.9 ± 17.5%, 28.5 ± 1.4%, and 24.6 ± 16.1%, respectively. Residual ,BSM comprised 1% of the new bone. Bone density for the contiguous resident bone ranged from 65 to 71%, and bone-implant contact ranged from 49 to 64%. Conclusions: Surgical implantation of rhBMP-2/,BSM appears an effective protocol for vertical alveolar ridge augmentation procedures and immediate dental implant Osseointegration and for onlay indications of lesser complexity. [source] Which region of the median palate is a suitable location of temporary orthodontic anchorage devices?CLINICAL ORAL IMPLANTS RESEARCH, Issue 3 200920 years, A histomorphometric study on human cadavers aged 1 Abstract Introduction: Endosseus implants can provide a reliable anchorage during orthodontic treatment. The midpalatal structures around the sutura palatina mediana (SPM) are of special interest due to increasing placement of orthodontic implants in this area. Knowledge about the osseous conditions at this site is necessary to predict the expected degree of implant osseointegration. Methods: The upper jaws of 10 human cadavers, aged 15,20 years, were decalcified, and cross-sectional specimens were obtained from four anterior-to-posterior palatal regions for histomorphometric analysis. The analyses focused on the amount of bone and the width of the SPM to determine the anatomical requirements for reliable insertion of palatal implants. Results: Bone density [bone-volume (BV)/ tissue-volume (TV)] in all measured areas was 40,60%. The maximum density was measured at the level of the first premolars (54.9±5.9%) and the least values (44.2±9.6%) were measured at the level of the interconnecting line of the canines. The mean width of the SPM varies from 1.2 to 0.3 mm in different sections of the palate. In the median sagittal plane, the mean values of bone height to nasal cavity reached >5 mm as far as the level distal of the second premolars. Bone height 2 mm paramedian to the SPM decreased consistently from anterior (4.3±0.9 mm) to posterior (2.5±0.8 mm). Conclusions: Our results indicate that the amount and quality of bone along the anterior palatal midline in 15-to-20-year olds is sufficient for orthodontic implantation. Even implantation posterior to the recommended first premolar level, at which orthodontic implants are most often placed, may be suitable. There are some limitations, however, due to small number of samples and variations of anatomical structures. [source] Bone density and primary stability in implant therapyCLINICAL ORAL IMPLANTS RESEARCH, Issue S2 2006Liene Molly Abstract Introduction: To improve patient comfort, deviations from the very successful standard osseointegration protocol are being developed. To keep implant failure rates as low as possible, the most perfect treatment planning and a good patient selection are extremely important. Because bone density plays an important role in implant outcome, known relations of bone density could improve treatment planning. Material and methods: A Pubmed search revealed 66 manuscripts investigating and discussing bone density of human jawbone whether or not related to implant stability or outcome. Forty-five of these will be discussed in this review. Results and discussion: Many pre-operative methods of jawbone density assessment are available. Most of those techniques correlate well with one another. Some are more elaborate to use in clinical practice. Primary stability measurements show significant correlations with different bone densities and also with implant outcome; however, not many studies investigate both at the same time. Conclusion: To investigate the outcome of adaptation methods of the surgical protocol with regard to the jawbone density, an objective pre-surgical determination of bone density is necessary. [source] Bone morphology and vascularization of untreated and guided bone augmentation-treated rabbit calvaria: evaluation of an augmentation modelCLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2005Christer Slotte Abstract Objectives: Cranial vault is widely used in experimental models on membranous bone healing in general, guided bone augmentation (GBA) studies being one example. To our knowledge, however, few studies on the characteristics of the untreated calvaria regarding bone density, vessel topography, and their intra/interindividual variations and associations are available. The aims of this investigation were to (1) map the large vessel topography of the skull vault, (2) describe the parietal bones of the adult rabbit histologically and morphometrically, and (3) histologically compare untreated parietal bone with parietal bone that had been treated with a GBA device. Material and methods: Ten adult untreated rabbits were microangiographed. General anesthesia was induced and the mediastinum was opened. Heparin and lidocaine were injected in the aorta followed by perfusion with India ink. After death, en bloc biopsies of the skull vault including the overlying soft tissues and dura mater were taken. The specimens were cleared with the Spalteholtz technique, microscopically examined, and digitally imaged. Thereafter, circular biopsies were harvested to obtain decalcified sections. In addition, sections from 14 GBA-treated rabbit skulls (of the same race, sex and age as the untreated animals) served as reference specimens for comparison. Histomorphometric examinations were carried out. Results: In the cleared specimens, all parietal bones were found to be supplied by one major branch of the meningeal artery. From each of these, separate branches supplied the dura wherein a fine vessel network covered the bone. No major vessels were found in the supracalvarial soft tissue. Numerous fine vessels were found within the periosteum and dura entering the cortical plates. The decalcified sections of the parietal bones revealed an outer and inner cortical plate enveloping a diploic space containing bone trabeculae, marrow tissue and larger sinusoids. Hollow connections were frequently found in both the outer and inner cortical plates in both the untreated and the GBA-treated specimens. These connections contained marrow tissue that extended to the periosteum and the dura. The morphometric measurements revealed similar proportions of cortical, trabecular, and marrow areas in the right and left untreated bones. The area of the outer cortical plate was significantly larger than the area of the inner cortical plate. Bone density was similar in the right and left untreated and GBA-treated specimens, as was the frequency and width of hollow connections through the cortical bone plates. Conclusions: The symmetry between the left and right parietal bones concerning the large vessel topography and the histomorphometric parameters assessed was high. Hollow connections in the cortical plates were frequently found. The bilateral use of the parietal bones is suggested to be reliable in experimental GBA models regarding the blood supply and bone quality. Résumé La voûte crânienne est souvent utilisée dans les modèles expérimentaux de guérison osseuse membranaire en général, l'augmentation osseuse guidée (GBA) étant un exemple. Peu d'études sur les crânes non-traités sont disponibles en ce qui concerne la densité osseuse, la topographie des vaisseaux et leurs variations intra/interindividuelles et leurs associations. Les buts de cette étude ont été 1) de cartographier la topographie des vaisseaux larges sur la voute crânienne, 2) de décrire les os pariétaux du lapin adulte histologiquement et morphométriquement et 3) de comparer histologiquement l'os pariétal non-traité avec celui traité par GBA. Dix lapins adultes non-traités ont subi une micro-angiographie. L'anesthésie générale a été effectuée et la partie médiane a été ouverte. De l'héparine et de la lidocaïne ont été injectées dans l'aorte suivies d'une perfusion avec de l'encre noire. Après la mort, des biopsies en blocs de la voûte crânienne comportant la dura mater et les tissus mous la recouvrant ont été prélevées. Les spécimens ont été estimés par la technique de Spalteholtz, examinés microscopiquement et des images digitales ont été réalisées. Des biopsies circulaires ont été prélevées pour obtenir des sections décalcifiées. Des sections de 14 crânes de lapins traités GBA (de même race, sexe et âge que les non-traités) ont servi de spécimens de référence pour comparaison. Des examens histomorphométriques ont été effectués. Dans les spécimens non-traités, tous les os pariétaux étaient irrigués par une branche majeure de l'artère méningée. De chacune de ces dernières, différentes branches abreuvaient la dura dans laquelle un réseau de vaisseau fins recouvrait l'os. Aucun vaisseau majeur n'a été trouvé dans le tissu mou ou sus-voûte. De nombreux vaisseaux fins ont été trouvés à l'intérieur du périoste et de la dura pénétrant qu'entre les bords corticaux. Les sections décalcifiées des os pariétaux ont révélé des bords corticaux interne et externe enveloppant un espace diploïque contenant de l'os trabéculaire, de la moelle osseuse et de larges sinusoïdes. Des connexions creuses étaient fréquemment trouvées tant dans les plaques corticales interne qu'externe et tant dans les spécimens non-traités que traités GBA. Ces connexions contenaient de la moelle qui allait jusqu'au périoste et la dura. Les mesures morphométriques ont révélé des proportions semblables de cortical, trabécules et moelle dans les les os non-traités. L'aire du bord cortical externe était significativement plus importante que l'aire du bord cortical interne. La densité osseuse était semblable dans les spécimens non-traités et traités GBA gauches et droits ainsi que la fréquence et la largeur des connexions creuses à travers les bords osseux corticaux. La symétrie entre les os pariétaux gauches et droits concernant la topographie des vaisseux larges et des paramètres histomorphométriques étaient importante. Les connexions creuses dans les bords corticaux était souvent trouvées. L'utilisation bilatérale des os pariétaux est proposée pour sa fiabilité dans les modèles GBA expérimentaux concernant l'apport sanguin et la qualité osseuse. Zusammenfassung Ziele:,Die Schädeldecke wird oft bei experimentellen Modellen zur bindegewebigen Knochenheilung verwendet. Ein Beispiel dafür sind Studien zur gesteuerten Knochenaugmentation (GBA). Soviel wir wissen, existieren jedoch nur wenige Studien über die Charakteristiken der unbehandelten Kalvaria bezüglich Knochendichte, Gefässtopographie und deren intra-/interindividuelle Variationen und Assoziationen. Die Ziele dieser Untersuchung waren (1) die Topographie der grossen Gefässe der Schädeldecke aufzuzeichnen, (2) die parietalen Knochen des ausgewachsenen Kaninchens histologisch und histomorphometrisch zu beschreiben, und (3) histologisch den unbehandelten parietalen Knochen mit parietalem Knochen, der mit einer GBA Einrichtung behandelt worden war, zu vergleichen. Material und Methoden:,Zehn ausgewachsene Kaninchen wurden mikroangiographisch untersucht. In Narkose wurde das Mediastinum eröffnet. Es wurde Heparin und Lidocain in die Aorta injiziert, darauf folgte die Perfusion mit India Tinte. Nach dem Tod wurden Blockbiopsien der Schädeldecke inklusive bedeckende Weichgewebe und Dura mater entnommen. Die Präparate wurden mittels der Spaltenholztechink gereinigt, mikroskopisch untersucht und digital aufgezeichnet. Danach wurden zirkuläre Biopsien gewonnen, um entkalkte Schnitte herzustellen. Zusätzlich dienten Schnitte von 14 GBA-behandelten Kaninchenschädeln (gleiche Rasse, Geschlecht und Alter wie die unbehandelten Tiere) als Referenzpräparate zum Vergleich. Es wurden histomorphometrische Untersuchungen durchgeführt. Resultate:,In den gereinigten Präparaten konnte gesehen werden, dass alle parietalen Knochen durch einen grossen Ast der Meningalarterie versorgt wurden. Separate Aeste dieser Arterie versorgten die Dura, wobei ein feines Gefässnetz den Knochen bedeckte. In den Weichgeweben auf der Kalvaria konnten keine grossen Gefässe gefunden werden. Im Periost und in der Dura waren zahlreiche feine Gefässe zu sehen, welche in die kortikalen Platten eintraten. Die entkalkten Schnitte der parietalen Knochen zeigten eine äussere und innere kortikale Platte, welche einen abgeschlossenen Raum mit Knochentrabekeln, Markgewebe und grossen Hohlräumen umschlossen. In der inneren und in der äusseren kortikalen Platte konnten oft sowohl bei den unbehandelten als auch bei den GBA-behandelten Präparaten hohle Verbindungen gefunden werden. Diese Verbindungen enthielten Markgewebe, dass sich bis zum Periost und der Dura erstreckte. Die morphometrischen Messungen zeigten sowohl in den rechten als auch in den linken unbehandelten Knochen ähnliche Proportionen zwischen kortikalem Knochen, trabekulärem Knochen und den Markarealen. Die Fläche der äusseren kortikalen Platte war signifikant grösser als die Fläche der inneren kortikalen Platte. Die Knochendichte war in den rechten und linken unbehandelten und in den GBA-behandelten Präparaten ähnlich, ebenso die Häufigkeit und die Breite der hohlen Verbindungen durch die kortikalen Platten. Schlussfolgerungen:,Die Symmetrie zwischen den rechten und linken parietalen Knochen bezüglich Topographie der grossen Gefässe und der untersuchten histomorphometrischen Parameter war gross. In den kortikalen Platten konnten häufig hohle Verbindungen gefunden werden. Es wird vorgeschlagen, dass die bilaterale Verwendung von parietalen Knochen bei experimentellen GBA-Modellen zuverlässig ist bezüglich Blutversorgung und Knochenqualität. Resumen Objetivos:,La bóveda craneal es ampliamente usada en modelos experimentales en cicatrización de hueso membranoso en general, siendo un ejemplo los estudios de regeneración ósea guiada (GBA). Que sepamos, sin embargo, se dispone de pocos estudios sobre las características del calvario no tratado con respecto a la densidad ósea, la topografía vascular, y sus variaciones intra/interindividuo y sus asociaciones. Las intenciones de esta investigación fueron (1) cartografiar la topografía de grandes vasos de la bóveda craneal, (2) describir histológica y morfométricamente los huesos parietales del conejo adulto, y (3) comparar histológicamente el hueso parietal no tratado con el hueso parietal tratado con un dispositivo de GBA. Material y Métodos:,Se llevaron a cabo microangiografías a diez conejos adultos sin tratar. Se indujo anestesia general y se abrió el mediastino Se inyectaron heparina y lidocaina en la aorta seguida por infusión de tinta de India. Tras la muerte, se tomaron biopsias en bloque de la bóveda craneal incluyendo los tejidos blandos superpuestos y de la duramadre. Los especimenes se aclararon con la técnica de Spalteholtz, se examinaron microscópicamente, y se tomaron imágenes digitales. Más adelante, se recogieron biopsias circulares para obtener secciones descalcificadas. Además, secciones de los cráneos de los conejos tratados con 14secciones descalcificadas. Además, secciones de los cráneos de los conejos tratados con 14 GBA (de la misma raza, sexo y edad que los animales no tratados) sirvieron como especimenes de referencia para la comparación. Se llevaron a cabo exámenes histomorfométricos. Resultados:,En los especimenes aclarados, todos los huesos parietales se encontró que estaban irrigados por una rama principal de la arteria meníngea. De cada una de estas, ramas separadas irrigaron la dura en donde una fina red de vasos cubrió el hueso. No se encontraron vasos mayores en el tejido blando supracalvario. Se encontraron numerosos vasos dentro del periostio y la dura entrando en las placas corticales. Las secciones descalcificadas de los huesos parietales revelaron una placa cortical interna y externa envolviendo un espacio diploico conteniendo trabéculas óseas, tejido medular y grandes sinusoides. Frecuentemente se encontraron conexiones huecas en las placas corticales internas y externas tanto en los especimenes sin tratar como en los tratados con GBA. Estas conexiones contenían tejido medular que se extendió hasta el periostio y la dura. Las medidas morfogenéticas revelaron proporciones similares de áreas corticales trabeculares y medulares en los huesos derecho e izquierdo no tratados. El área de la placa cortical externa fue significativamente mayor que el área de placa cortical interna. La densidad ósea fue similar en el lado derecho e izquierdo no tratados y en los especimenes tratados con GBA, así como la frecuencia y la anchura de las conexiones huecas a lo largo de las placas óseas corticales. Conclusiones:,La simetría entre los huesos parietales izquierdos y derechos concernientes a la topografía vascular y los parámetros histomorfométricos valorados fue alta. Las conexiones huecas en las placas corticales se encontraron con frecuencia. Se sugiere que el uso bilateral de huesos parietales es fiable como modelo experimental GBA respecto al suministro de sangre y calidad ósea. [source] Bone formation at titanium porous oxide (TiUniteÔ) oral implants in type IV boneCLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2005Yi-Hao Huang Abstract Background: Several oral implant design advances have been suggested to overcome poor bone quality, an impediment for successful implant treatment. A novel titanium porous oxide (TPO) surface has been shown to offer favorable results in several settings. The objective of this study was to evaluate the local bone formation and osseointegration at TPO-modified implants in type IV bone. Method: Three TPO surface-modified implants (TiUniteÔ) were installed into the edentulated posterior maxilla in each of 8 Cynomolgus monkeys. The animals were injected with fluorescent bone labels at 2, 3, 4 and 16 weeks post-surgery and were euthanized at week 16 when block biopsies were collected for histologic analysis. Results: The predominant observation of the TPO implant surface was a thin layer of new bone covering most of the implant threads. Mean (±SE) bone,implant contact for the whole study group was 74.1±4.8%. There was a significant variability in bone,implant contact between animals (P=0.0003) and between sites of the same animal (P<0.0001). The variance in bone,implant contact was 30% larger among sites of the same animal than between different animals (187.5 vs. 144.8, respectively). There was a small but significant difference in bone density immediately outside, compared to within the threaded area of the implants (37.1±3.2% vs. 32.1±3.2%, P<0.0001). Bone density outside the implant threads was significantly correlated (,=0.682, P<0.0001) with the bone density within thethreaded area. Bone density within the threaded area was significantly correlated (,=0.493, P=0.0002) with bone,implant contact, whereas bone density outside the implant threads did not have a significant effect (,=0.232, P=0.1). Conclusions: The results suggest that the TPO surface possesses a considerable osteoconductive potential promoting a high level of implant osseointegration in type IV bone in the posterior maxilla. Résumé Différents nouveaux modèles d'implants ont été suggéréspour tenter de compenser la mauvaise qualité osseuse qui est un problème pour le traitement implantaire à succès. Une nouvelle surface en oxyde poreux de titane (TPO) a apporté des résultats favorables en différentes occasions. L'objectif de cette étude a été d'évaluer la formation osseuse locale et l'ostéoïntégration d'implants modifiés TPO dans de l'os de qualité type IV. Trois implants dont la surface était modifiée TPO (TiUniteTM) ont été insérés dans un maxillaire édenté postérieur de huit singes cynomolgus. Les animaux ont subi des injections de marqueurs osseux par flurorescence à deux, trois, quatre et seize semaines après la chirurgie et ont été euthanasiés à la semaine 16 quand des biopsies en bloc ont été prélevées pour l'analyse histologique. L'observation prédominante de la surface implantaire TPO était une fine couche de nouvel os couvrant la plupart des filetages implantaires. La moyenne ±SE du contact os-implant pour tout le groupe étudiéétait de 74±5%. Il y avait une variation significative dans le contact os-implant entre les animaux (P<0,0003) et entre les sites d'un même animal (P<0,0001). La variance du contact os-implant était 30% plus importante parmi les sites du même animal qu'entre différents animaux (respectivement 187 et 145). Il y avait une différence significative bien que faible dans la densité osseuse immédiatement á l'extérieur comparéà l'intérieur des zones à filetage des implants (37±3% vs 32±3%, P<0,0001). La densité osseuse en dehors des filetages implantaires était en corrélation significative (ß=0,682, P<0,0001) avec la densité osseuse à l'intérieur des zones de filetage. La densité osseuse à l'intérieur des zones de filetage était en corrélation significative (ß=0,493, P<0,0002) avec le contact os-implant, tandis que la densité osseuse en dehors des filetages implantaires n'avait pas d'effet significatif (ß=0,232, P=0,1). Ces résultats suggèrent que la surface TPO possède un potentiel ostéoconducteur considérable qui peut promouvoir une ostéoïntégration implantaire de haut niveau dans l'os de type IV dans la région maxillaire postérieure. Zusammenfassung Ziel: Um trotz schlechter Knochenqualität die Aussicht auf eine erfolgreiche implantologische Behandlung zu verbessern, wurden verschiedene Entwicklungen des Designs von Zahnimplantaten vorgeschlagen. Bei verschiedenen Gelegenheiten hat eine neue poröse Titanoxidoberfläche (TPO) scheinbar vorteilhafte Resultate gezeigt. Das Ziel dieser Studie war, die lokale Knochenbildung und die Osseointegration von Implantaten mit einer TPO-modifizierten Oberfläche im Typ IV Knochen zu untersuchen. Methode: In die zahnlosen posterioren Oberkiefern eines jeden von 8 Cynomolgus-Affen implantierte man drei Implantate mit einer TPO-modifizierten Oberfläche (TiUnite®). Den Tieren wurden 2, 3, 4 und 16 Wochen nach dem chirurgischen Eingriff fluoreszierende Knochenmarker injiziert und in der Wochen 16 wurden sie eingeschläfert und für die histologische Analyse Blockbiopsien entnommen. Resultate: Die wichtigste Beobachtung bei der TPO-Implantatoberfläche war eine dünne Schicht neuen Knochens, welche die meisten Schraubenwindungen des Implantates bedeckte. Der mittlere Knochen-Implantatkontakt (±SE) betrug in der ganzen Testgruppe 74.1±4.8%. Man fand eine signifikante Variabilität des Knochen-Implantatkontaktes unterhalb der Tiere (P=0.0003) und auch unterhalb der verschiedenen Impantate desselben Tieres (P<0.0001). Innerhalb der Implantate desselben Tieres war die Varianz des Knochen-Implantatkontaktes bis zu 30% grösser, als zwischen den verschiedenen Tieren (187.5 gegenüber 144.8). Man fand auch einen kleinen, aber signifikanten Unterschied der Knochendichte im Bereich direkt ausserhalb der Schraubenwindungen, verglichen mit dem inneren Bereich (37.1±3.2% gegenüber 32.1±3.2%, P<0.0001). Diese beiden Knochendichten waren aber signifikant miteinander korreliert (0.682, P<0.0001). Die Knochendichte innerhalb der Schraubenwindungen korrelierte signifikant mit dem Knochen-Implantat-Kontakt (ß=0.493, P=0.0002), währenddem die Knochendichte ausserhalb des Bereiches der Schraubenwindungen in dieser Beziehung keine signifikante Korrelation aufwies (ß=0.232, P=0.1). Zusammenfassung: Die Resultate lassen vermuten, dass die TPO-Oberfläche eine beachtliche osteokonduktive Fähigkeit hat, die im posterioren Oberkieferbereich mit Typ IV Knochen zu einer sehr guten Osseointegration führt. Resumen Antecedentes: Se han sugerido varios avances en los diseños de los implantes orales para superar una baja calidad de hueso, un impedimento para un tratamiento exitoso de implantes. Se ha presentado una nueva superficie de óxido de titanio poroso (TPO) que ofrece resultados favorables en diversas situaciones. El objetivo de este estudio fue evaluar la formación local de hueso y la osteointegración en implantes TPO modificados en hueso tipo IV. Método: Se instalaron tres implantes (TiUniteTM) con superficie modificada TPO en el maxilar posterior edéntulo en 8 monos Cynomolgus. Los animales fueron inyectados con marcadores óseos fluorescentes en la semana 2, 3, 4 y 16 tras la cirugía y se sacrificaron en la semana 16 recogiéndose biopsias en bloque para análisis histológicos. Resultados: La observación predominante de la superficie TPO del implante fue una fina capa de hueso nuevo cubriendo la mayor parte de las roscas. El contacto hueso-implante medio (±SE) para todo el grupo de estudio fue de 74.1±4.8%. Hubo una variabilidad significativa en el contacto hueso-implante entre animales (P=0.0003) y entre lugares del mismo animal (P<0.0001). La varianza en el contacto hueso-implante fue un 30% mayor entre lugares del mismo animal que entre los diferentes animales (187.5 vs. 144.8, respectivamente). Hubo una pequeña pero significativa diferencia en la densidad ósea inmediatamente por fuera comparada con el área roscada de los implantes (37.1±3.2% vs. 32.1±3.2%, P<0.0001). La densidad ósea por fuera de las roscas del implante se correlacionó significativamente (,=0.682, P<0.0001) con la densidad ósea entre las áreas de roscas. La densidad ósea entre las áreas de roscas se correlacionó significativamente (,=0.492, P<0.0002) con el contacto hueso implante, mientras que la densidad ósea por fuera de las roscas del implante no tuvo un efecto significativo (,=0.232, P=0.1). Conclusiones: Los resultados sugieren que la superficieTPOposee un considerable potencial osteoconductivo promoviendo un alto nivel de osteointegracióndel implante en hueso tipo IV en el maxilar posterior. [source] Amylin and Bone Metabolism in Streptozotocin-Induced Diabetic RatsJOURNAL OF BONE AND MINERAL RESEARCH, Issue 5 2001Marie-Noëlle Horcajada-Molteni Abstract Amylin (AMY) is a 37 amino acid peptide cosecreted with insulin (INS) by pancreatic ,-cells and absent in type 1 diabetes, a condition frequently associated with osteopenia. AMY binds to calcitonin receptors, lowers plasma calcium concentration, inhibits osteoclast activity, and stimulates osteoblasts. In the present study, we examined the effects of AMY replacement on bone loss in a streptozotocin (STZ)-induced rodent model type 1 diabetes. Of 50 male Wistar rats studied, 40 were made diabetic with intraperitoneal STZ (50 mg/kg; plasma glucose concentrations >11 mM within 5 days). Ten nondiabetic control (CONT) rats received citrate buffer without STZ. Diabetic rats were divided into four groups (n = 10/group) and injected subcutaneously with rat AMY (45 mg/kg), INS (12 U/kg), both (same doses), or saline (STZ; diabetic controls) once per day. After 40 days of treatment and five 24-h periods of urine collection for deoxypyridinoline (DPD), the animals were killed, blood was sampled, and femurs were removed. The left femur was tested for mechanical resistance (three-point bending). The right femur was tested for total, diaphyseal (cortical bone), and metaphyseal (trabecular bone) bone densities using dual-energy X-ray absorptiometry (DXA). Bone was ashed to determine total bone mineral (calcium) content. None of the treatments had any significant effect on femoral length and diameter. Untreated diabetic rats (STZ; 145 ± 7N) had lower bone strength than did nondiabetic CONT (164 ± 38; p < 0.05). Total bone mineral density (BMD; g/cm2) was significantly lower in STZ (0. 2523 ± 0. 0076) than in CONT (0.2826 ± 0.0055), as were metaphyseal and diaphyseal densities. Diabetic rats treated with AMY, INS, or both had bone strengths and bone densities that were indistinguishable from those in nondiabetic CONT. Changes in bone mineral content paralleled those for total BMD (T-BMD). Plasma osteocalcin (OC) concentration, a marker for osteoblastic activity, was markedly lower in untreated diabetic rats (7. 6 ± 0. 9 ng/ml); p < 0. 05) than in nondiabetic CONT (29. 8 ± 1. 7; p < 0. 05) or than in AMY (20. 1 ± 0. 7; p < 0. 05). Urinary DPD excretion, a marker for bone resorption, was similar in untreated and AMY-treated diabetic rats (35.0 ± 3.1 vs. 35.1 ± 4.4 nmol/mmol creatinine), intermediate in rats treated with INS (49.9 ± 2.7), and normalized in diabetic rats treated with both agents (58.8 ± 8.9 vs. 63.2 ± 4.5 in CONT). Thus, in our STZ rat model of diabetic osteopenia, addition of AMY improved bone indices apparently by both inhibiting resorption and stimulating bone formation. [source] Assessment of correlation between computerized tomography values of the bone, and maximum torque and resonance frequency values at dental implant placementJOURNAL OF ORAL REHABILITATION, Issue 12 2006I. TURKYILMAZ summary, The aim of this study was to determine the bone density in the designated implant sites using computerized tomography (CT), the fastening torque values of dental implants, and the implant stability values using resonance frequency analysis. Further aim was to evaluate a possible correlation between bone density, fastening torque and implant stability. Eighty-five patients were treated with 158 Brånemark System implants. CT machine was used for preoperative evaluation of the jawbone for each patient, and bone densities were recorded in Hounsfield units (HU). The fastening torque values of all implants were recorded with the OsseoCare equipment. Implant stability measurements were performed with the Osstell machine. The average bone density and fastening torque values were 751·4 ± 256 HU and 39·7 ± 7 Ncm for 158 implants. The average primary implant stability was 73·2 ± 6 ISQ for seventy implants. Strong correlations were observed between the bone density, fastening torque and implant stability values of Brånemark System TiUnite MKIII implants at implant placement (P < 0·001). These results strengthen the hypothesis that it may be possible to predict and quantify initial implant stability and bone quality from pre-surgical CT diagnosis. [source] Bone density and primary stability in implant therapyCLINICAL ORAL IMPLANTS RESEARCH, Issue S2 2006Liene Molly Abstract Introduction: To improve patient comfort, deviations from the very successful standard osseointegration protocol are being developed. To keep implant failure rates as low as possible, the most perfect treatment planning and a good patient selection are extremely important. Because bone density plays an important role in implant outcome, known relations of bone density could improve treatment planning. Material and methods: A Pubmed search revealed 66 manuscripts investigating and discussing bone density of human jawbone whether or not related to implant stability or outcome. Forty-five of these will be discussed in this review. Results and discussion: Many pre-operative methods of jawbone density assessment are available. Most of those techniques correlate well with one another. Some are more elaborate to use in clinical practice. Primary stability measurements show significant correlations with different bone densities and also with implant outcome; however, not many studies investigate both at the same time. Conclusion: To investigate the outcome of adaptation methods of the surgical protocol with regard to the jawbone density, an objective pre-surgical determination of bone density is necessary. [source] Pamidronate treatment of bone fibrous dysplasia in nine children with McCune-Albright syndromeACTA PAEDIATRICA, Issue 2 2000R Lala McCune-Albright syndrome is a rare genetic disorder consisting of skin and bone dysplasia and peripheral endocrinopathies. Little data have been collected regarding bisphosphonate treatment of bone fibrous dysplasia in paediatric patients with this syndrome. The aim of our study was to investigate the therapeutic efficacy of pamidronate in these patients. Nine patients with moderate to severe forms of bone fibrous dysplasia were treated with pamidronate intravenously (0.5-1 mg/ kg/daily for 2-3 d) at 0.5-1-y intervals. Patients were treated over a time period of 0.5-3.5 y. During treatment no spontaneous fracture occurred. Bone pain and gait abnormality due to pain disappeared after 2-3 therapeutic cycles. Cranial asymmetry and limb length discrepancy remained unchanged. Elevated serum alkaline phosphatase and urine hydroxyproline values were reduced by the treatment, demonstrating drug activity at the lesional level. The effectiveness of pamidronate was also seen at the non-lesional level through an increase in bone density. Radiographic and scintigraphic evidence of lesion healing was not attained. Pamidronate treatment can ameliorate the course of bone fibrous dysplasia in children and adolescents with McCune-Albright syndrome. [source] Akt2/PKB,-sensitive regulation of renal phosphate transportACTA PHYSIOLOGICA, Issue 1 2010D. S. Kempe Abstract Aim:, The protein kinase B (PKB)/Akt is known to stimulate the cellular uptake of glucose and amino acids. The kinase is expressed in proximal renal tubules. The present study explored the influence of Akt/PKB on renal tubular phosphate transport. Methods:, The renal phosphate transporter NaPi-IIa was expressed in Xenopus oocytes with or without PKB/Akt and Na+ phosphate cotransport determined using dual electrode voltage clamp. Renal phosphate excretion was determined in Akt2/PKB, knockout mice (akt2,/,) and corresponding wild-type mice (akt2+/+). Transporter protein abundance was determined using Western blotting and phosphate transport by 32P uptake into brush border membrane vesicles. Results:, The phosphate-induced current in NaPi-IIa-expressing Xenopus oocytes was significantly increased by the coexpression of Akt/PKB. Phosphate excretion [,mol per 24 h per g BW] was higher by 91% in akt2,/, than in akt2+/+ mice. The phosphaturia of akt2,/, mice occurred despite normal transport activity and expression of the renal phosphate transporters NaPi-IIa, NaPi-IIc and Pit2 in the brush border membrane, a significantly decreased plasma PTH concentration (by 46%) and a significantly enhanced plasma 1,25-dihydroxyvitamin D3 concentration (by 46%). Moreover, fractional renal Ca2+ excretion was significantly enhanced (by 53%) and bone density significantly reduced (by 11%) in akt2,/, mice. Conclusions:, Akt2/PKB, plays a role in the acute regulation of renal phosphate transport and thus contributes to the maintenance of phosphate balance and adequate mineralization of bone. [source] Is self-reported alcohol consumption associated with osteoporotic mandibular bone loss in women?EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 1 2009Olivia Nackaerts The aim of this study was to determine whether alcohol consumption would predict mandibular bone quality and quantity in a large European female population. In total, 672 middle-aged and elderly women (45,70 yr of age; standard deviation = 6) were recruited in the study. Alcohol consumption was recorded through a self-reported questionnaire. Mandibular cortical width was measured, by five observers, in the mental foramen region on panoramic radiographs. Mandibular bone density, expressed as aluminium thickness, was recorded on intra-oral radiographs. Alcohol consumption was associated with a reduction of mandibular bone density and cortical width. This association was higher in subjects with excessive alcohol consumption, defined in the present study as > 14 units consumed per week. This study showed reduced jaw-bone quality in older individuals and in those with increased alcohol consumption. [source] Physical activity for prevention of osteoporosis in patients with severe haemophilia on long-term prophylaxisHAEMOPHILIA, Issue 3 2010M. KHAWAJI Summary., Physical activity has been considered as an important factor for bone density and as a factor facilitating prevention of osteoporosis. Bone density has been reported to be reduced in haemophilia. To examine the relation between different aspects of physical activity and bone mineral density (BMD) in patients with severe haemophilia on long-term prophylaxis. The study group consisted of 38 patients with severe haemophilia (mean age 30.5 years). All patients received long-term prophylaxis to prevent bleeding. The bone density (BMD g cm,2) of the total body, lumbar spine, total hip, femoral neck and trochanter was measured by dual energy X-ray absorptiometry. Physical activity was assessed using the self-report Modifiable Activity Questionnaire, an instrument which collects information about leisure and occupational activities for the prior 12 months. There was only significant correlation between duration and intensity of vigorous physical activity and bone density at lumber spine L1-L4; for duration (r = 0.429 and P = 0.020) and for intensity (r = 0.430 and P = 0.019); whereas no significant correlation between all aspects of physical activity and bone density at any other measured sites. With adequate long-term prophylaxis, adult patients with haemophilia are maintaining bone mass, whereas the level of physical activity in terms of intensity and duration play a minor role. These results may support the proposition that the responsiveness to mechanical strain is probably more important for bone mass development in children and during adolescence than in adults and underscores the importance of early onset prophylaxis. [source] The CAG repeat polymorphism within the androgen receptor gene and maleness,INTERNATIONAL JOURNAL OF ANDROLOGY, Issue 2 2003Michael Zitzmann Summary The androgen testosterone and its metabolite dihydrotestosterone exert their effects on gene expression and thus effect maleness via the androgen receptor (AR). A diverse range of clinical conditions starting with complete androgen insensitivity has been correlated with mutations in the AR. Subtle modulations of the transcriptional activity induced by the AR have also been observed and frequently assigned to a polyglutamine stretch of variable length within the N-terminal domain of the receptor. This stretch is encoded by a variable number of CAG triplets in exon 1 of the AR gene located on the X chromosome. First observations of pathologically elongated AR CAG repeats in patients with X-linked spino-bulbar muscular atrophy showing marked hypoandrogenic traits were supplemented by partially conflicting findings of statistical significance also within the normal range of CAG repeat length: an involvement of prostate tissue, spermatogenesis, bone density, hair growth, cardiovascular risk factors and psychological factors has been demonstrated. The highly polymorphic nature of glutamine residues within the AR protein implies a subtle gradation of androgenicity among individuals within an environment of normal testosterone levels providing relevant ligand binding to ARs. This modulation of androgen effects may be small but continuously present during a man's lifetime and, hence, exerts effects that are measurable in many tissues as various degrees of androgenicity and represents a relevant effector of maleness. It remains to be elucidated whether these insights are important enough to become part of individually useful laboratory assessments. [source] | |||||||||||||||||||||||||||||||